Letter to the Editor: People need insurance when they become sick

The current debate about whether to expand Medicaid highlights our confusion between health and health care. Opponents of expansion refer to the point that previous investments in Medicaid have not improved health outcomes for Medicaid recipients. The intent of Medicaid, as well as other health insurance plans, is to give us access to the medical/health care system when we are sick.

While some, rightfully, criticize our health care system as a "sick care" system, the fact is people get sick. And when they get sick they need medical care. But this care is not what makes us healthy. In fact, we know from the research that very little (about 10 percent) of what makes us healthy comes from the health care system and medical professionals.

Our health is determined primarily by the lifestyle and behavior choices we make. And these choices are primarily governed by our socio-economic status and whether we live in supportive physical and social environments. If Medicaid recipients experience poor health outcomes, it is far more a result of low wages and poor housing than their being Medicaid recipients.

A greater focus by health care professionals on outcomes is necessary. But this greater commitment and comparable financial investment will only marginally make us healthier. Investing in healthy communities that allow the "healthy choice to be the default choice" will make us healthier. Investing in public health will make us healthier.

But, when we get sick, and even the healthiest people get sick, we all need health insurance so we can get better.

-Rick Kozin, director, Polk County Health Department, Des Moines

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Letter to the Editor: People need insurance when they become sick

The current debate about whether to expand Medicaid highlights our confusion between health and health care. Opponents of expansion refer to the point that previous investments in Medicaid have not